Objective To investigate the diagnostic value of intraductal ultrasonography (IDUS) for bile duct stones by comparing between magnetic resonance cholangiopancreatography ( MRCP), endoscopic retrograde cholangiography (ERC) and IDUS. Methods ERC was performed in 30 patients with suspected extrahepatic cholelithiotic after MRCP. IDUS was applied through guide wire after ERC, and stones were removed if necessary. Results MRCP detected bile duct stones in 22 cases, misdiagnosed bile duct floc as stones in 2 and missed stones in 2 others. The accuracy, sensitivity and specificity of MRCP in diagnosis of bile duct stone were 86. 7% (26/30), 91. 7% (22/24), and 66. 7% (4/6), respectively. ERC detected bile duct stones in 23 cases, misdiagnosed bile duct air bubble as stones in 2 and missed stones in 1. The accuracy , sensitivity and specificity of MRCP in diagnosis of bile duct stone were 90% (27/30), 92% (23/25) and 66.7% (4/6) , respectively. IDUS detected 24 cases of bile duct stones, 4 bile duct floc and 2 air bubble without any misdiagnosis. The accuracy, sensitivity and specificity of IDUS in diagnosis of bile duct stone were 100%. Conclusion IDUS, safe and reliable, is superior to ERC and MRCP in diagnosis of bile duct stone.

A novel electrochemical method based on dehydroabietylamine schiff base( DBS) and multi-walled carbon nano-tubes( MWCNTs) composite modified glassy carbon electrode was presented for determination of Pb2+. The electrochemical behaviors of Pb2+on the modifled electrode were investigated by cyclic voltammetry ( CV) and differential pulse anodic stripping voltammetry ( DPASV ) . The results showed that under the optimized conditions including 0 . 2 mol/L NaAc-HAc used as supporting buffer ( pH 5 . 5 ) , -1 . 1 V of accumulating potential, 250 s of accumulating time, the oxidation peak current was proportional to Pb2+concentration in the range between 1 × 10-8 mol/L and 1 × 10-6 mol/L with the linear regression equation as I(μA)= 6. 6173c(μmol/L)+0. 2597(R=0. 9971) and the detection limit as 5. 0×10-9 mol/L (S/N=3). The proposed sensor was successfully employed to determine Pb2+ in real samples with satisfactory results. In addition, this method showed the advantages of simple operation, short assay time, good accuracy, satisfactory efficiency and good selectivity for determination of low concentration lead in water samples.

Objective To explore the relationship between MspⅠpolymorphism of CYP1A1 gene and susceptibility to breast cancer in Yi nationality in Yunnan province. Methods The gene polymorphism of restriction enzyme of 3′-terminal of CYP1A1 was detected by PCR-RFLP in 60 healthy Yi women , 51 Yi women with breast cancer, 235 healthy Han women, and 250 Han women with breast cancer. Results The distribution frequency of CYP1A1-MspⅠgenotypes was significantly higher in Yi women with breast cancer (51.0%) than in the healthy Yi women (33.3%) (P < 0.05), an the allele C had a higher frequency in women with breast cancer than in healthy controls (P < 0.05). Significant differences of frequencies were found in genotypes TT, TC and CC between women with breast cancer and healthy controls (P < 0.05). The risks of TC and CC for breast cancer were 1.19 and 1.95 folds respectively to TT genotype. But as compared with Yi women , the distribution frequency of CYP1A1-MspⅠ genotypes did not differ between Han women with breast cancer and in the healthy control (P > 0.05), and there were no differences in three genotype frequencies (P > 0.05). Conclusions Gene polymorphism of CYP1A1 genotypes may be associated with the risk of breast cancer in Yi nationality but not in Han nationality in Yunnan. The mutation of CYP1A1 gene may increase the incidence of breast cancer in Yi nationality.

Objectives: Public healthcare data have become crucial to the advancement of medicine, and recent changes in legal structure on privacy protection have expanded access to these data with pseudonymization. Recent debates on public healthcare data use by private insurance companies have shown large discrepancies in perceptions among the general public, healthcare professionals, private companies, and lawmakers. This study examined public attitudes toward the secondary use of public data, focusing on differences between public and private entities. Methods: An online survey was conducted from January 11 to 24, 2022, involving a random sample of adults between 19 and 65 of age in 17 provinces, guided by the August 2021 census. Results: The final survey analysis included 1,370 participants. Most participants were aware of health data collection (72.5%) and recent changes in legal structures (61.4%) but were reluctant to share their pseudonymized raw data (51.8%). Overall, they were favorable toward data use by public agencies but disfavored use by private entities, notably marketing and private insurance companies. Concerns were frequently noted regarding commercial use of data and data breaches. Among the respondents, 50.9% were negative about the use of public healthcare data by private insurance companies, 22.9% favored this use, and 1.9% were “very positive.” Conclusions This survey revealed a low understanding among key stakeholders regarding digital health data use, which is hindering the realization of the full potential of public healthcare data. This survey provides a basis for future policy developments and advocacy for the secondary use of health data.

BACKGROUND: The emergency physician(EP)'s interpretation of the electrocardiogram(ECG) is important in determining the disposition of patients evaluated in an emergency department(ED) for chest pain o other cardiac complaints. This particularly important in life-threatening ECG findings. When the cardiologist's final interpretation was defined as the correct one, the concordance compared with the EP was reported to be 50-60%, while the missed diagnosis of acute myocardial infarction(AMI) was reported as 0.6-8.0%, which could be deleterious to the patient. METHOD AND MATERIAL : One hundred and twenty eight ECGs were interpreted by two residents from each year residency. ED records of the study patients were reviewed, and the EP's and cardiologist's ECG interpretations were compared. The ECGs were classified by severity according to the following system: class I, normal or minor abnormalities only; class II, abnormalities with potential to alter case management; and class III, potentially life-threatening abnormalities. RESULTS: The overall concordance between EP's and cardiologist's ECG interpretations was 59.3% and the concordance comparing each year residency showed no statistical significant difference (p value less than 0.05). The underdiagnosed rate was 48.4%, 32.0%, 23.4%, 22.7% for first, second, third and fourth year residency respectively, and 2.3%, 5.5%, 10.9%, 5.5% respectively for the overdiagnosed rate. CONCLUSION: Although the overall concordance showed a relatively high result in our study, the concordance of class III ECG resulted a much lower rate. Therefore, additional studies are needed to identify variables that contribute to ED ECG misinterpretation and to develop methods to resolve these difficulties. Assessment of department ECG misinterpretation would be useful in focusing on resident and staff education.
Case Management ; Chest Pain ; Diagnosis ; Education ; Electrocardiography* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Internship and Residency

BACKGROUND: For the Ficat Ⅱ of femoral head necrosis especially with osteoporosis, core decompression with or without acellular tissue engineered bone can result in a higher incidence of femoral head collapse. OBJECTIVE: To analyze the clinical effect of core decompression plus implantation of acellular tissue engineered bone with titanium rods in the treatment of early necrosis of the femoral head. METHODS: Thirty-five hospitalized patients with early necrosis of the femoral head (40 hips) were enrolled in the study and assigned into a observation group (15 cases with 20 hips, including 10 hips of Ficat I, 10 hips of Ficat Ⅱ) and a control group (20 cases with 20 hips, including 11 hips of Ficat Ⅰ, 9 hips of Ficat Ⅱ). Core decompression plus implantation of acellular tissue engineered bone with titanium rods were conducted in the observation group, while Bouche decompression with implantation of acellular tissue engineered bone was done in the control group. All the patients were followed up for 1 year. Visual analogue scale (VAS) score, Harris hip function score, and progression in necrosis of the femoral head were compared between two groups. RESULTS AND CONCLUSION: VAS scores and Harris scores at 1-year follow-up in both groups showed better outcomes (P ＜ 0.001). At the end of 1-year follow-up visit, the Harris score was significantly higher in the observation group than the control group (P＜0.05), while there was no difference in the mean VAS scores between the two groups (P ＞ 0.05). For Ficat II patients, the excellent/good rate in the observation group was higher than that in the control group at the last follow-up (80% vs. 40%, P＜0.05). According to the Ficat staging, the effective rate in the observation group was higher than that in the control group (90% vs. 80%, P＜0.05). During the postoperative 1-year follow-up visit, Ficat Ⅰ patients presented with better repair of lesions, no degeneration of the hip joint, and no subchondral bone collapse. Overall, it is an effective treatment for early necrosis of the femoral head by core decompression plus implantation of acellular tissue engineered bone with or without titanium rods; however, co-implantation with titanium robs can show better short-term outcomes.

Humans ; Temperature ; Cities/epidemiology* ; Hot Temperature ; Cardiovascular Diseases/epidemiology* ; China/epidemiology* ; Mortality

OBJECTIVEIn the interest of establish planting base of Angelica sinensis on a large scale, enhance economic benefit, and improve decision-making reasons, the eco-climatic applicability of A. sinensis was studied.

METHODUsing integral regression, eco-climatic applicability and the effect of meteorological conditions for the yield of A. sinensis' were analysed by field experimental data.

RESULTSelected > or =0 degrees C accumulated temperature and annual precipitation as leading index, altitude as assistant index, yield and rate of finished products as reference index, the integrated eco-climatic division index and the planting division applicability of A. sinensis was confirmed.

CONCLUSIONAccordancing to theory of climate similitude and leading index summarisation, combining with assistant index and reference index, the integrated division index of eco-climate was confirmed. The planting division of co-climate applicability was divided into 5 grades as best suitable, suitable hypo-suitable, just suitable and no suitable regions. At the same time,the way to enhanced utilizing efficiency of eco-climate resources was brought forward.

Angelica sinensis ; growth & development ; Climate ; Ecosystem ; Plant Roots ; growth & development ; Plants, Medicinal ; growth & development ; Rain ; Temperature